Created by
Gary B. Rollman,
Emeritus Professor of Psychology,
University of Western Ontario
(In addition to links below, see weekly archives in the right column)

Wednesday, October 08, 2008

Pain expert questions insurance payout caps - Nova Scotia News

Limiting insurance payments to $2,500 for people with soft-tissue injuries perpetuates the stigma that they're exaggerating or making up their claims, a pain management specialist testified Tuesday in a lawsuit challenging Nova Scotia's insurance cap.

This falsehood often causes society to turn on victims and deny them adequate treatment for their chronic pain, said Dr. Mary Lynch of the Capital district health authority's pain management clinic in Halifax.

"It really challenges every fibre of a person's being," Dr. Lynch said of chronic pain, a condition she described as "potentially disabling."

She testified in Supreme Court in Halifax that there is a three-year wait to be seen at the Halifax pain clinic. Another 1,000 people are in line to be assessed at the clinic in Sydney.

The longer someone has to wait for treatment, she said, the greater the risk the pain will get worse and conditions such as depression will develop.

This province's Conservative government put its cap in place in 2003, when insurance companies said they were struggling and motorists' premiums were skyrocketing. The legislation included a 20 per cent reduction in premiums.

In 2005, the Nova Scotia Coalition Against No-Fault Insurance and two car accident victims from Halifax filed a lawsuit challenging the legislation, arguing the cap is unfair for certain groups of people.

On cross-examination, the province's lawyer questioned Dr. Lynch's belief that people with chronic pain are being treated unfairly by society.

"Are you seriously suggesting that everyone who gets a bruise is stigmatized?" Alex Cameron asked. Dr. Lynch disagreed, saying she's based her conclusions on what she's heard over and over again from her patients.

Mr. Cameron asked if it's difficult to know if those people are telling the truth, to which she admitted that some patients feel compelled to present their cases "in a stronger fashion than is reality."

Dr. Lynch also admitted to lawyer Jeff Galway that she is not an expert on the factors contributing to high insurance premiums.

Mr. Galway, who represents the Insurance Bureau of Canada, then drew her attention to a press release issued by his client that states the primary factor driving up costs in Nova Scotia is the high number of soft-tissue claims.

Mr. Cameron opened the province's case Tuesday afternoon with Dr. Edwin Rosenburg, a psychiatrist who specializes in post-traumatic stress disorder.

He testified that a patient's psychological state can often physically manifest itself in the form of pain, and gave the example of a soldier afraid to fire a gun developing a paralysis in his shooting arm.

That could be the case with many chronic pain sufferers, he said, some of whom also complain of stress, anxiety or depression.

But on cross-examination, lawyer Barry Mason suggested that in most cases patient's pain is real, and that it's the stigma they're trying to defraud the insurance companies that is upsetting them.

Dr. Rosenburg responded by saying he finds nothing "demeaning" in the suggestion that people with soft-tissue injuries are to blame for rising insurance costs and said he doubts such a statement would be of great concern to individual patients.